Whiplash: Facts and Symptoms.

One of my primary roles as a Registered Massage Therapist is to evaluate and alleviate pain. In order for me to treat both properly and effectively, it is best that I have a clear understanding of the discomfort being felt. When a client first comes to see me, an initial assessment is performed including a series of informative questions, thorough palpation, and special testing. My clients insight on the pain being temporarily experienced, provides me with a respectable approximation of the injury at hand. I seek to develope a full understanding of the experience.whip-2.122906

However, I always found it somewhat difficult, for I myself have never experienced it. I’ve had my fair share of mild strains and sprains from playing sports, and some increased tension in certain muscles due to overuse. Still my funny bone is as close as I’ve gotten to experiencing nerve pain, and a torn muscle? Well I can’t imagine, but with the knowledge and understanding I gain from the assessment, I strive to provide a compassionate, effective treatment. Which brings me to this article, for following a slightly unfortunate event, I have gained insight on the emotional and physical grounds of whiplash.

Whiplash is an acceleration-deceleration injury to the head and neck. Commonly caused in motor-vehicle accidents, sports or other trauma. Just following the event I found significant relief in the fact I was aware of the Mechanism of Injury and the Healing Stages of Soft Tissue. Let’s look at the Mechanism of Injury, the circumstance in which an injury occurs, in a rear impact accident to understand the direction of the head and neck on impact.

In the first phase the vehicle is struck from behind. The persons torso is hit by the back of the seat moving it forsymptoms-of-whiplash.122419ward with the vehicle while the head stays due to inertia (the resistance of any physical object to any change in its state of motion, including changes to its speed and direction). The torso then moves abruptly upwards. It is in this phase where it’s possible for the cervical discs to be injured.

In the second phase the vehicle and torso reach there peak forward acceleration placing the head and neck into hyperextension. Force occurs between the cervical and thoracic spine. Anterior neck muscles and ligaments, facet and temporomandibular joint injuries are possible in this phase.

In phase three the head and neck are now at peak forward acceleration while the vehicle and torso are slowing down.

Brining us to the fourth phase where the head and torso are now at full deceleration. Shoulder harness restrains the torso while head and neck continue to flex forward into hyperflexion. It is in this final phase that posterior neck muscle, and ligament injuries are possible.

These four phases happen within milliseconds.

In these four phases it’s easy to see how any structures in the neck, upper thorax, and head may be injured in a whiplash.

The Mechanism of Injury in the event of a rear impact accident can be very traumatic firing our Sympathetic Nervous System. Also known as the Fight or Flight response, which is an acute response to stress. It is during this response that chemicals like adrenaline, noradrenaline, and cortisol are released into our bloodstream. Our respiratory rate increases, blood is shunted away from our digestive tract and directed to our muscles switch are requiring more energy, our awareness intensifies and our perception of pain diminishes.neck pain

At the time of injury our body goes into the AcuteProtection Phase of the Stages of Healing. In the acute phase our body’s aim is to protect the injury from further damage. Swelling is at a peak during this phase and symptoms/full extent of injury may not be clear for the first 24-72 hours. This phase usually last a couple of days depending on the severity of injury.

So know that your aware of what your body has and will continue to go through for the next 72 hours, what is it that you can do to aid its recovery?

First you should always seek medical attention. They will check for serious injury and address it accordingly.

However, if they say your good to go home, then GO HOME. REST to avoid pain and further damage. You may not feel particularly bad following the accident but as we mentioned earlier, adrenaline has flooded our bloodstream dulling our pain receptors for a while. It is important to go home and allow healing to take place rather than go to work and place demand on your injured muscles.

Drink plenty of WATER during the days following the accident. Extra fluid can help reduce inflammation by carrying away waste products caused by the injury.

ICE is also excellent for control of the pain and inflammation experienced in the acute phase.Try icing the upper back and neck for 20-30 mins each every 2-3 hours.

The sudden shock during trawhiplash.123248uma may cause us to “gasp”, tightening our diaphragm (primary breathing muscle) depriving us of healing oxygen. Some focused deep breathing for 5-10 mins each day will prove helpful in relaxing the diaphragm and other accessory breathing muscles affected.

Try to AVOID sports, strenuous activity, and yoga, your body in vulnerable in the acute phase and we want to avoid making any injury worse.

GENTLE MOVEMENT however, (light walking, and pain free range of motion) is encouraged even for just a couple minutes, to prevent the muscles from atrophy (waste away, due to degeneration of cells).

These simple tips can go a long way in helping you through the acute stage of healing. If you take it easy in the acute stage you will be rewarded in much faster healing and a greater likelihood of complete recovery. Seeking alternative health care such as Physiotherapy and Massage Therapy may be a smart decision, for they can assess, guide, and treat individuals through all three Stages of Healing.

– Nicole van Zutphen, RMT

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